Background : Honey given as oral drops significantly precipitate epithelialization of the lateral palatal defects post two-flap palatoplasty by 2.1 times. Honey is believed to reduce wound contraction, scar formation, and would contribute as an important factor that will result in a satisfactory maxillary growth. The aim of this study is to evaluate maxillary growth as the long-term effect of rapid epithelialization of the palates treated by honey oral drops. Method : This is a case control study consisting of 2 groups; comparing maxillary growth of the UCCLP patients that were and were not given honey as oral drops following their two-flap palatoplasty in 2011-2012. The cephalometric measurements were recorded and the dental cast are evaluated using GOSLON Yardstick method.Result : This study included a total of 20 patients. Goslon Yardstick type IV are the most frequent GOSLON on both groups (40%) with moderate inter-rater reliability between examiner 1-2 and 2-3 (kappa; 0.583 and 0.512) and substantial between examiner 1-3 (kappa 0.716). Forty-percent of SNA angle in the honey group were considered as normal, while only 20% normal SNA angle were found in the control group.Conclusion: Honey oral drops following two-flap palatoplasty resulted in satisfactory SNA angle. As the completion of maxillary growth occurs at the age of 20, the results of this study would only serve as a preliminary report. Other measures to support maxillary growth should also be taken into account. Further studies are warranted to discover innovations in surgical technique that may be a major contributing factor in maxillary growth. Keywords: Maxillary growth, Two Flap Palatoplasty, honey

Introduction: Cleft Lip and Palate is the most common craniofacial anomaly, and cleft lip and palate repair is widely performed. Alveolar cleft accompanies 75% of cleft lip cases and requires alveolar bone graft (ABG) surgery at mixed dentition age. However, studies on rates of ABG surgery are scarce. Objective: This study aims to investigate the low popularity of ABG and orthodontic care among patients with ABG history at Cleft and Craniofacial Centre, Cipto Mangunkusumo Hospital, Jakarta. Method: A total of 771 patients had orofacial cleft surgeries throughout 2015 to 2021. A descriptive analysis of labioplasty, palatoplasty, and ABG surgeries was presented. Questionnaire-based qualitative analysis of ABG was obtained from the patient’s guardians to evaluate the limitation and experience of conducting the surgery at our institution. Results: We distributed questionnaires to 13 patients with a history of ABG. ABG accounted for only 5% of total orofacial cleft surgeries. The average age of ABG surgery and orthodontic care initiation was 11 and 11.8 years old, respectively. About 82% had access to preoperative and postoperative orthodontic care; however, only 11% received PSO before 9 years old. The satisfaction rate was 100% and 75% in ABG patients with and without orthodontic care, respectively, reporting improved feeding, speech, teeth alignment, and esthetic result. Conclusion: Orofacial cleft management requires a multistage, comprehensive, and multidisciplinary approach. The number of ABG surgeries is low in developing countries, attributed to unequal access to ABG and orthodontic care, suggesting that limitations of knowledge, geography, and economy play a big role in Indonesian healthcare.

Background: In the last decade, there are various methods of bone grafting in plastic surgery. Cancellous bone is more often used as bone graft than cortical bone due to its high osteoconductivity and osteogenic capability. The synthetic materials for bone graft such as tricalcium phospate (TCP) and hydroxy-apatite can be use as new alternative for bone grafting surgery. Methods: The PubMed®  databases were searched using the terms: ‘bone graft OR bone grafting’ AND ‘cancellous bone OR iliac crest OR tibia’ AND ‘tricalcium phospate OR tricalciumphospate OR tri calcium phospate’, restricted to English language, and to a publication period from January 2010 to January 2017. The inclusion criteria were any kind of research paper that compared the utility of TCP synthetic graft and autograft as a bone graft. Results: Out of 139 selected studies, only 8 met the inclusion criteria.  In 6 publications TCP graft has similar outcome and in 1 publication have a better result in reducing post operative complication.  Conclusion: TCP graft can be used as substitution for autograft in particular clinical conditions and surgical methods.

Background : Conventional Two Flap Palatoplasty technique will produce lateral defects without any periosteal coverage. These denuded lateral defects are prone to contamination and infection. These will result in wound contraction, scar formation and maxillary growth impairment. In 2011, we studied “The Non Denuded Palatoplasty” technique. This technique precipitated the epithelialization process of the lateral defects. Faster epithelialization is expected to decrease wound contraction and good maxillary growth. Method : This is a case control study to compare the maxillary growth of 2 groups consists of unilateral cleft lip and palate patients repaired with “The Non Denuded Palatoplasty” technique and Conventional Two Flap Palatoplasty. The outcome will be evaluated from cephalometry and the dental cast for each patient is evaluated using GOSLON YARDSTICK method. Data will be analyzed using SPSS version 20. Result : A total of 4 patients in The Non Denuded Palatoplasty group and 10 in the Conventional Two Flap Palatoplasty. The cephalometric SNA, SNB and ANB point showed Class III skeletal jaw relationship or deficient maxilla. Meanwhile the GOSLON yardstick type III are the most common GOSLON on both group with good inter-ratter reliability (p=0.839) based on Mann Whitney test. In these study, there was no correlation between cephalometric variables with GOSLON score. Conclusion: Our results showed that modification (The Non Denuded Palatoplasty) technique made no statistically significant difference to the maxillary growth. However this study has several limitations, one of which being the small sample size due to family, social and other factors that are beyond the control of the investigating team. Also the evaluation was conducted in patients aged 7-9 years, hence the result of this study is not the final outcome. Keywords: maxillary growth evaluation, cephalometry, Goslon Yardstick, two flap palatoplasty